CN117500453A

CN117500453A - Omnidirectional multi-unit abutment system for screw-attached dental prostheses

Info

Publication number: CN117500453A
Application number: CN202280039807.9A
Authority: CN
Inventors: B·D·科福德; C·A·鲁迪西尔
Original assignee: Full Arch Solutions LLC
Current assignee: Full Arch Solutions LLC
Priority date: 2021-06-03
Filing date: 2022-06-03
Publication date: 2024-02-02
Also published as: IL309005A; CA3215615A1; EP4312872A1; WO2022256699A1; KR102673153B1; US12023220B2; EP4312872A4; US20220387144A1; US20240090982A1; JP2024524840A; AU2022286486B2; BR112023024391A2; KR20240008380A

Abstract

A multi-unit abutment for aligning a dental implant and a screw-attached prosthesis having a coping is disclosed. The multi-unit abutment has a threaded base post and a ball for attachment to an implant. The rotating housing surrounds the ball and may be secured in place with a locking screw. A drive feature on the ball allows a tool to pass through the locking screw to drive the base post into the implant while the multi-unit assembly is in a linear configuration. The rotating housing is then positioned and fixed at the desired tilt angle and azimuth angle. The swivel housing has a mating surface for the top cover. When the prosthesis is positioned on the implant abutment, the locking screw is still accessible through the hole in the cap. Various embodiments for capturing a spin housing on a ball are disclosed. Methods for improving passive alignment of a prosthesis with an implant are described.

Description

Omnidirectional multi-unit abutment system for screw-attached dental prostheses

Cross Reference to Related Applications

The present disclosure claims priority from U.S. provisional patent application No. 63/196227 filed on 6/3 of 2021, the entire contents of which are incorporated herein by reference.

Background

Different systems have been introduced to attach dental prostheses to dental implants to replace one or more natural teeth. To simplify future modification or replacement needs, it is desirable to use a mechanical system such that there is a reversible attachment between the implant and the prosthesis, rather than directly bonding these components together. These systems may include features that provide both proper alignment and retention to facilitate acceptable use by the patient. Intermediate components such as titanium bases (also known as coping) and detachable abutments (abuttings) are commonly employed to provide proper registration between the dental prosthesis, one or more implants embedded in the patient's jaw, and soft tissue and any remaining natural teeth. These intermediate elements may be attached to each other with screws, ball joints, snap mounts, glue or other mechanical means.

In addition to the manufacturing costs, the simplicity of the screw-attached system provides some benefits over the snap-in system. The mounting pressure between the top cover and the base is easily controlled by the torque applied to the screw to tighten the screw. This axial tension control and self-alignment nature of the engaged threads provides greater certainty in the engagement force and relative orientation of the components. Even if the screw breaks, techniques for removing debris without damaging surrounding components are known. The screws also have the benefit of independent removal, as each cap can be loosened individually. Tilting the prosthesis after screw removal to disengage one cap does not cause re-engagement of the other cap.

In the case of a single tooth crown attachment, the titanium base and abutment surfaces preferably include features that remove rotational symmetry about the azimuth axis in the mating of the abutment and coping surfaces. Rotational locking features may also be included in these single mount systems. Such rotational fixation is generally not required when the prosthesis contains multiple caps for attachment to multiple abutments. For example, a 30 degree conical mating surface for multiple interface positions is sufficient to provide full registration. This form is shown in the drawings of the present disclosure for convenience, but is not meant to be limiting.

The goal of all implants attached prostheses is to have the prosthetic superstructure passively fit to the implant to avoid stress on the prosthesis or stress on the osseointegration process of the implant. These stresses may cause problems during initial loading or long-later trimming (crop up). Mismatches can cause mechanical and biological problems in single implantation and multiple implantation treatments. Mechanical problems may include loosening of the prosthetic set screw and abutment screw and cracking of components, including the screw. Biological problems may include discomfort, progressive marginal bone loss, bacterial infection, microbial plaque accumulation, and implant loosening.

Having a passive fit initially or being able to readjust or redo the components later to accommodate the changes is important for successful prosthesis functionality and survival. Obtaining a passive fit remains a challenge due to the increased tolerances and the introduction of misalignment and distortion in manufacturing the prosthesis. The use of a direct pick-up stamp process is beneficial but improvements are still needed. Buzayan, M.M. and Yunnus N.B. paper 2014, "Passive Fit in Screw Retained Multi-unit Implant Prosthesis Understanding and Achieving: A Review of the Literature",Journal of Indian Prosthodontic Society14 (1), 16-23 (https:// doi.org/10.1007/s 13191-013-0343-x.) have provided an overview of passive fit challenges.

The more popular treatment options for edentulous patients include placement of four to eight implants in the edentulous jaw and installation of a prosthetic arch. The transmucosal abutment is secured to the implant and is intended to remain in place indefinitely. While it is desirable that the axes of all implants be positioned parallel to one another, the underlying bone structure generally results in the implants being mounted at an angle to the desired mutual orientation. A "multi-unit abutment" is a popular descriptor of a particular type of transmucosal abutment for the repair of edentulous jaws with a single prosthesis (i.e., a full arch prosthesis).

A multi-unit abutment (commonly referred to as a "MUA") is a fairly easy way to improve the divergence angle of an implant with the option of 0, 17 and 30 degree angle correction. Typically, a 0 degree MUA is easier to position because the abutment is positioned coincident with the linear axis of the implant. 17 and 30 degree MUAs typically include "screw in" indicators that are relatively long and difficult to work in confined spaces (e.g., the posterior portion of the jaw) where these abutments are typically positioned to compensate for the distal angle (disto-angle) of the posterior implant that was promoted in 2004 by Paolo Maolo doctor.

Several alternative abutment designs exist for restoring the dental arch. Although most implant companies have established the MUA geometry employed by Nobel Biocare, there have been some attempts to improve the weaknesses of this geometry. For example, the Dentsply Implants Astra EV system uses a "mulTibase" abutment that improves the lack of coverage of the prosthetic screw in a multi-unit abutment. Neoss uses a form of MUA that "reduces the height of the abutment" by using a female connection as opposed to the standard male connection of MUA. Regardless of the benefits of these improved designs, each design requires a clinician to customize a particular inventory with a particular angular correction and height. Examples of the complexity of inventory management are when the implant system provides multiple implant/abutment connections (e.g., narrow and conventional platforms) and multiple heights (e.g., 1.5mm, 2.5mm, 3.5mm, 4.5mm, etc.) and different angles or tilt angles (e.g., 0 degrees, 17 degrees, and 30 degrees) to the MUA. In order to maintain sufficient inventory to make good preparation for full arch implants, a fixed immediate loading process may be required to have three tilt angle options times the number of platform options times the number of reasonable tissue heights for the amount of implant expected to be placed (four in accordance with the Paolo Maolo protocol).

The resulting inventory formula is as follows:

3 (degree option) ×2 (plateau connection) ×2 (different tissue height) ×4 (implant) =48 (multi-unit abutment).

This inventory problem increases when the multi-unit abutment system also requires unique implants, titanium bases and prosthetic fasteners. This inventory management complexity is further exacerbated when practitioners prefer different vendor systems in different patient situations, or when different practitioners in practice prefer different vendor supplies.

In addition to the complexity of inventory management, there are limitations on the discrete nature of "angle correction" (e.g., limited to three specific angles of 0 °, 17 °, and 30 °) and the internal connection of the implant about its longitudinal axis (which may be referred to as azimuth angle). In many cases, the inner hexagon limits the possibility to 6 azimuth positions, 60 degrees from one position to the next. In some cases, 0 degrees will be too small a tilt angle correction, but 17 degrees is too large. The same applies to 17 to 30. Or 17 degrees may be a suitable tilt correction, but due to the 6-position limitation in the hexagon, the required 17 degree correction cannot be applied to the desired azimuth direction of the required correction. The same applies to the 30 degree correction. Novice clinicians of full arch implant treatments are tired of coping with the selection and positioning of multi-unit consoles. The procedure time is prolonged, which may lead to an increased patient morbidity.

Although there is uncertainty as to whether the angled implant is more susceptible to loss of osseointegration than a straight abutment, all implants do impose higher mechanical stresses and strains on the bone structure than natural teeth. The natural tooth may move an order of magnitude more in its socket than an implant embedded in bone. Such natural vibration dampers help to cushion the range of magnitudes and directions of forces applied from the bone to the teeth. Screw loosening is related to bending and settling effects of the screw joint, where the initial surface microroughness initially keeps the joined components apart, but the high points gradually wear. The micro-gap of the initial mechanical mismatch between the elements in the prosthetic superstructure may be too small to be detected with a detector, but large enough to concentrate the mechanical forces of different magnitudes from different directions during mastication. These micro-gaps may still be large compared to bacteria that can penetrate and grow in the lumen of the entire dental prosthetic superstructure device.

There is no acceptable passive fit threshold for long term success due to a wide range of variables, application details, and difficulties in situ measurements. The quality of the fit can be tested with the analog in the dental laboratory and at the time of installation in the patient, but this is not a strict science. For example, a "one screw test" for mating involves tightening only one screw at one end of the prosthesis and then seeking lift at the opposite end. A variation of the "screw resistance test" in this case involves inserting and setting screws in sequence and then observing whether rotation over 180 degrees is required to obtain a torque of, for example, 10 Ncm. Failure of a prescribed pass-fail test criterion means that the prosthesis needs to be reworked or replaced. Since the same process will be used to manufacture the replacement, it cannot be determined that the replacement will be properly aligned.

Even if all the multi-unit abutments are initially perfectly aligned and fixed with the implant and prosthesis, variations over time may occur. For example, the prosthesis may deform, or the bone structure may change, or the fastener may become loose or break more likely. In many prior art systems, the prosthesis must be removed entirely in an attempt to adjust orientation, re-tighten the multi-unit abutment fasteners, replace components, or even make and match entirely new prostheses possible. The ineffective trial-and-error fit cycle for improved alignment is frustrating to both the patient and the dentist. Replacement of a single failed multi-unit abutment from several abutments and proper alignment with existing prostheses may be more difficult than initial installation alignment. There is a need for a method of adjusting the orientation of a multi-unit abutment orientation while a prosthesis is in place.

Some commercial systems require sequential assembly of the multi-unit abutment elements in place during installation of the multi-unit abutment elements into the patient's mouth. This increases the chance of the patient accidentally swallowing the component. Some systems require the use of multiple tools, which also increases the complexity of the procedure and increases the procedure time.

In order to address one or more of the above-described challenges and limitations of existing multi-unit basestations on the market, embodiments of new multi-unit basestations are disclosed herein. These units are designated as omnidirectional in the sense that they can be positioned over a continuous range of orientations sufficient to correct for implant angular differences commonly found in common practice. Although the above discussion is based on structural reasons, angled implants may also be preferred for aesthetic reasons as well, for example, to redirect the screw access holes in a single crown. Embodiments of an omnidirectional multi-unit abutment are provided that have advantages in terms of inventory management, placement procedures, options for angle correction, and flexibility, improve passive fit, and eliminate limitations of angle correction or other issues for existing multi-unit abutment systems for single implant crowns and multiple implant prostheses.

Disclosure of Invention

Some embodiments of the present invention include a multi-unit abutment for screw attachment to a dental implant that allows the titanium base to be positioned at a user selected rotational and tilt angle relative to the implant. This seated orientation may be fixed prior to bonding the titanium base to the prosthesis, and in some embodiments may be adjusted or tightened by removing the prosthesis set screw while the titanium base is otherwise held to the abutment. In this way, the final relative orientation of the adjustable abutment can be directly influenced by the fixed position of the titanium base in the prosthesis. This can correct or reduce misalignment due to accumulation of positioning errors with respect to the initial position of the base in the prosthesis manufacturing step.

Certain embodiments of the invention include a multi-unit abutment assembled outside the patient's mouth, mounted to a driving tool in a linear arrangement to attach it to an implant, reorienting the abutment portion interfacing with a titanium base (which is not aligned with the axis of the implant), and then fixing the orientation. The titanium base may then be attached to the multi-unit abutment with a prosthetic screw.

Certain embodiments of the present invention allow a single driving tool to screw the multi-unit abutment into the implant and lock the orientation of the abutment surface. Other embodiments use different driving tools for these processes.

Some embodiments of the invention include a ball and a rotating portion that are capable of relative tilting or rotation but are constrained not to separate from each other. Some embodiments allow for fixing the relative orientation of the ball and the rotator by applying pressure on opposite sides of the ball. Some embodiments of the invention include a locking screw attached to the rotating portion to exert pressure on opposite sides of the ball. In some embodiments, the multi-unit abutment can be installed in the implant by passing a driving tool through the hole of the locking screw. In some embodiments of the invention, the locking screw comprises threads for a prosthetic screw. In some embodiments, the locking screw may be accessible through a titanium base secured to the prosthesis.

One embodiment describes a system for aligning and attaching a dental prosthesis to an implant using a prosthetic screw, wherein the prosthetic screw includes a head and a threaded shaft, the system comprising:

a base station base having a longitudinal axis, the base station base comprising:

a proximal end comprising a ball portion and a base portion drive interface; and

a distal end comprising threads for attachment to the implant; and

a rotating housing having an inner surface and an outer surface, wherein the rotating housing includes a rotating bore proximate the distal end and a threaded bore at the proximal end; and

A locking screw having a longitudinal axis, wherein the locking screw comprises:

a portion having external threads compatible with the threaded bore of the rotating housing; and

a portion having internal threads sized to engage the prosthesis threaded shaft; and

locking the screw drive interface; and wherein rotating the locking screw is capable of fixing the orientation of the longitudinal axis of the locking screw in an orientation that is not parallel to the longitudinal axis of the abutment base.

One embodiment describes how an omnidirectional multi-unit base station can be used in a method comprising:

attaching the locking screw to the rotating housing surrounding the abutment base, wherein the ball portion is loosely constrained within the rotating housing, wherein the abutment base thread extends through the rotation aperture to form a multi-unit abutment assembly;

inserting a base drive tool tip through the locking screw to engage the base drive interface;

presenting a base station base drive tool and a multi-unit base station assembly to an implant;

rotating the abutment base drive tool to attach the abutment base to the implant to a first torque;

Disconnecting the base station base drive tool from the base station base drive interface;

moving the rotating housing to a different orientation;

rotating the locking screw driving tool to fix the orientation of the rotational housing axis relative to the implant axis to a second torque;

presenting a prosthesis comprising a titanium base to the implant abutment system; and

the prosthesis is attached to the implant abutment with a prosthesis screw.

Some embodiments describe a system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment comprising:

a ball and housing assembly, the ball and housing assembly comprising:

a base including a abutment drive interface for threaded attachment to the implant; the base includes a first end having a ball and a second end having a threaded post, the threaded post having a longitudinal axis; and wherein the threaded post is designed to be screwed into a dental implant with a predetermined torque;

a housing portion having an inner surface and an outer surface; wherein the housing portion has a first end with a hole and a second end with a locking screw; and wherein the ball is captured within the housing portion, wherein the threaded portion of the base post extends through the aperture;

A titanium base including a hole on the proximal end and an interface on the distal end, the distal end designed to be mounted on the exterior of the housing portion in a known position; and

one or more driving tools designed to engage the abutment driving interface and the locking screw; wherein at least one driving tool is insertable through the titanium base hole to engage the locking screw; and wherein tightening the locking screw exerts pressure on the ball to fix the orientation of the housing.

For the purposes of this disclosure, a dental prosthesis is broadly defined as anything that includes one or more dental coping or titanium bases that can be installed onto and removed from one or more implant abutments. Different titanium base designs are known in the dental industry, and the systems and methods disclosed herein may be adapted to work with many commercially available types of titanium bases, including pick-up caps, temporary cylinders, inserts, and impression caps. Implant abutments are known in the dental industry to have interfaces compatible with these titanium bases. Since the mechanical interfaces are identical, for purposes of this disclosure, the implant abutment is considered to be a generic term that includes abutment analogs. The description of a abutment alignment system and procedure method with a titanium base and implant installed in the jaw of a patient should also be considered to describe the equivalent inventive concepts that may be used with titanium base and implant analogs in a dental laboratory. Common geometries include a conical titanium base that seats to a conical implant abutment. Although this form of system is used in the figures and the following discussion, the concepts of the present invention are applicable to other types of titanium bases and stations.

The inventive concepts disclosed herein may be used with different types of dental prostheses. The dental prosthesis may be any form of impression used in a dental laboratory to assist in creating and testing the dental prosthesis. The dental prosthesis may also be a dental prosthesis manufactured in a dental laboratory using a physical model made from impressions, a newly manufactured dental prosthesis, or an existing prosthesis converted for screw attachment. Dental prostheses are defined to include single tooth appliances (e.g., crowns), or any multi-bridge or denture. These prostheses may include a titanium base to provide a detachable interface to provide orientation with a suitable abutment attached to the patient's jaw or gums. Although this name implies the use of multiple implants, the multi-unit abutment may also be used separately to provide for the installation of implants for a single dental prosthesis. Thus, the term "multi-unit abutment" will be used herein, whether a single implant or a multiple implant application, as well as any form of dental prosthesis. The multi-unit abutment for the inventive concepts disclosed herein includes threads to mount a prosthesis having a titanium base onto the abutment and mount the abutment into an implant. While this concept describes a typical male thread in a multi-unit abutment that mates with a female thread on an implant, this is for ease of disclosure. Unless explicitly stated or limited by functional necessity, certain inventive concepts may be applied to systems having female threads in a multi-unit abutment that engage with screws of male threads in an implant. These are considered to be direct variations of the inventive concept. One benefit of the typical female threads of implants preferred for abutment attachment is standardization and implementation flexibility. For the same reason, a prosthetic screw with a male thread and a commercially available titanium base is preferred, but may not be necessary to obtain some benefit from the disclosed inventive concepts. These types of variations are considered to be within the scope of the present disclosure.

The systems and methods disclosed herein may be used with prostheses for attachment to implants in the upper and lower jaws. As a result, those portions of the system that are oriented downward for the lower jaw will be oriented upward for the upper jaw and vice versa. For convenience, the disclosure of embodiments of the inventive concept limited to a single jaw orientation is considered to disclose embodiments for the opposite jaw orientation. When a clinician's perspective is involved, the proximal portion is closer to the clinician than the distal portion. Although terms such as top are opposite the term bottom and proximal are opposite distal, their actual relative orientation will be determined by the context in which they are used. The terms tissue side and intaglio (intaglio) are used interchangeably to refer to the side of the prosthesis opposite the occlusal or relief surface.

The disclosed system of the present invention is advantageously applicable to screw-attached prostheses and abutments. The key benefits of screw attachment are variable tightening torque and reversibility. In this disclosure, the terms permanent, semi-permanent, final and final are used interchangeably when referring to screw attachment. The finally attached conventional screw may still be removed by accessing the screw and rotating the screw in a direction opposite to the direction used for attachment. For the purposes of the screw-attached prosthesis of the present disclosure, the attachment is semi-permanent, permanent or final in the sense that frequent attachment and removal is not expected for normal use. Instead, temporary screw attachment is applied to the planned procedure period or other expected interval. Positioning of the titanium base in the dental prosthesis can be effectively performed by a lift-off procedure using the temporary screw disclosed in commonly owned U.S. patent 11,311,354, which is incorporated herein by reference in its entirety. However, the utility of the inventive concepts in this disclosure is not dependent on the use of the systems or methods disclosed in the referenced patents.

Screw attachment of the abutment to the implant is also described in embodiments. However, some of the disclosed concepts may be readily adapted for other systems that do not utilize screw attachment of dental components to implants, such as snap systems or magnetic systems. Such modifications are considered obvious variations of the inventive concepts described in the present disclosure.

Removal of the semi-permanent or final screw is often facilitated by the opportunity for problems or improvements. Accessing the screw to apply a tool for removal may require removal of material covering the screw, which is added for aesthetic reasons. Some embodiments provide for adjusting the orientation of the multi-unit abutment when the prosthesis is positioned on the multi-unit abutment without semi-permanent or final screw positioning. This may improve the passive fitting of the prosthesis to the implant at initial installation or after the system has been used for a long period of time. While implant abutments are typically initially used to position the titanium base in the prosthesis, individual alignment errors will necessarily accumulate during subsequent processing or over time. The apparatus and methods disclosed below allow the collection of titanium bases in the prosthesis to be used to fine tune the alignment of the multi-unit abutment to the collection of titanium bases, thereby improving the overall passive fit.

The elements disclosed herein may be characterized as having an axis or a longitudinal axis. In the case of a long cylindrical object like a pencil, the longitudinal axis passes through the centre of the cylinder from the writing end of the pencil to the rubber end. The longitudinal axis is conventionally considered along the length or longest dimension of an object characterized by a decreasing size length, width and thickness. If not a pencil, but a bolt is considered, the axis or even the longitudinal axis may be considered to pass through the center, from the engaging end of the thread through the center of the head of the bolt. In this case, the rotation axis and the longitudinal axis are the same even for a stubby bolt. In the present disclosure, the axis or longitudinal axis of the threaded object will be the same as the axis of rotation of the threads. The width will be measured perpendicular to the axis of rotation. Thus, a conventional nut with internal threads will be considered to have a longitudinal axis passing through the middle of the central bore, i.e., where the axis of the mating bolt will be when engaged. By extension, an unthreaded washer captured between a bolt and a nut will also be considered to have a longitudinal axis or simply axis that is centered in the bore and perpendicular to the plane of the washer. For the purposes of this disclosure, linear assembly of the components is produced by arranging the component axes of the assembly substantially co-linearly. Therefore, even if the axis of the washer can move near the common axis of the bolt and the nut due to the washer hole being larger than the width of the threaded portion of the bolt, the assembly including the bolt and the nut with the washer will be a linear assembly. External threads are generally characterized as having a small diameter measured at the root of the thread and a large diameter measured at the crest of the thread. Internal threads are generally characterized as having a small diameter at the crest and a large diameter at the root. Unless otherwise indicated, the width of the external thread on the shank of the bolt is defined as the major diameter or maximum deviation from the axis of the bolt, i.e. the dimension that can be measured with a caliper. The width of the internal thread of the nut is defined as the minor diameter of the internal thread or the smallest deviation from the axis of the nut, i.e. the dimension that can be measured with a pin or plug gauge.

In the present disclosure, some threaded elements that are tightened by relative rotation may have some features that may be considered nut-like, while other threaded elements are screw-like, such as elements having both female and male threads. In discussing the concepts of the present invention, the term screw will be used generically in this disclosure for these threaded elements. However, the external threads on the screw will be considered male threads and the internal threads will be considered female threads.

For the purposes of this disclosure, the term ball refers to a mechanical structure that includes some geometric properties of the ball. This is a more general term that allows only some portions of the surface of the ball to have a substantially spherical surface, while other portions may deviate significantly from having a spherical surface. The spherical surface is preferred for some directional flexibility and sealing of the contact surface between the ball and the structure that may be repositioned and locked in place relative to the ball by rotation. The housing is what at least partially surrounds the ball. The contact surface between the exterior of the ball and the interior of the housing is preferably a spherical surface section of approximately the same diameter to increase the frictional grip at the beginning of the securing process or to provide a sealing surface to prevent biological contamination of the interior of the assembly. While it may be preferable to have flexibility to position the axis of the titanium base and the prosthetic screw at an angle of 30 degrees relative to the axis of the implant, and at any rotational angle about either axis, the mating elements of the implant, ball, housing, or titanium base may be designed to limit such omnidirectional angular flexibility. Such limiting modifications are known in the art and may be used with some of the inventive concepts disclosed herein.

In an oral prosthesis, it is common to fix threaded elements to a desired torque, or to fasten some elements to a higher or lower torque than some other elements in combination. For example, if three elements are screwed together in sequence, it is generally preferred that the first two elements are assembled with a higher torque so that the third element can be attached or removed without affecting the attachment of the first two elements. In some cases, the torque is quantified with a torque wrench, and sometimes the practitioner's experience is used to determine when the torque is sufficient to function as desired. For the purposes of this disclosure, these torques will be considered to be predetermined, whether assessed quantitatively or qualitatively. If a quantitative minimum torque value or acceptable range is specified as necessary, it is desirable to make the measurement with a tool or with some indicating structure built into the component. In some embodiments, it may be desirable to prevent over-torquing, which may cause structural or biological stresses on the implant seat or prosthesis through controlled failure of the sacrificial element. Such controlled mechanical failure may be due to both the characteristics of the inherent failure characteristics of the intentionally weakened structure or the uniform structure.

Other terms in the specification and claims of this application should be construed using their commonly accepted, common meaning defined by any context in which they are used. The terms a or an, as used herein, are defined as one or more than one. The term "plurality" as used herein is defined as two or more than two. The term another, as used herein, is defined as at least a second or more. The terms including and/or having, as used herein, are defined as comprising (i.e., open language). The term coupled, as used herein, is defined as connected, although not necessarily directly, and not necessarily mechanically. The terms "about" and "substantially" refer to ± 10%. Reference throughout this specification to "one embodiment," "certain embodiments," and "an embodiment" or similar terms means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the present invention, and thus, the phrases appearing in various places throughout the application are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments without limitation. The term "or" as used herein is to be interpreted as inclusive or meaning any one or any combination. Thus, "a, B or C" means any one of the following: "A; b, a step of preparing a composite material; c, performing operation; a and B; a and C; b and C; A. b and C. An exception to this definition will occur only when a combination of elements, functions, steps or acts are in some way inherently mutually exclusive.

The drawings are for purposes of illustrating certain convenient embodiments of the invention and are not to be construed as limiting the invention. The term "means" prior to the current word of operation indicates a desired function for which there are one or more embodiments, i.e., one or more methods, devices, or means for achieving the desired function, and may be selected from these or their equivalents by those skilled in the art in view of the disclosure herein, and the use of the term "means" is not intended to be limiting. Other objects, features, embodiments and/or advantages of the present invention will become apparent from the following description taken in conjunction with the accompanying drawings.

Drawings

Fig. 1 is a bottom exploded isometric view of a first embodiment of an omnidirectional multi-unit abutment assembly having a titanium base and a prosthetic screw.

Fig. 2 is a top exploded isometric view of a first embodiment of an omnidirectional multi-unit abutment assembly having a titanium base and a prosthetic screw.

Fig. 3 is a side plan view of the assembly system of fig. 1 and 2, without the prosthetic screw, with the longitudinal axes of the components aligned.

Fig. 4 is a side cross-sectional view of the assembly system of fig. 3 taken along a longitudinal axis.

Fig. 5 is a side plan view of the assembly of fig. 4 after reorienting the rotating housing and titanium base.

Fig. 6 is a top isometric assembly view of the omnidirectional multi-unit base station of fig. 1 and 2.

Fig. 7 is a side cross-sectional view of the assembly of fig. 3 and 4 during attachment to an implant. Fig. 7A of the small drawing includes the relative proportions of the implant driving tool.

Fig. 8 is a side cross-sectional view of the assembly of fig. 3 and 4 after reorienting the rotating housing and titanium base as shown in fig. 5, showing the orientation secured with the locking screw. Fig. 8A of the small drawing includes the relative proportions of the locking screw driving tool.

Fig. 9 is a side cross-sectional view of the assembly of fig. 8 after securing the titanium base with a prosthetic screw.

Fig. 10 is a bottom assembled isometric view of a second embodiment of an omnidirectional multi-unit base and titanium base in a linear configuration.

Fig. 11 is a side plan view of the embodiment of fig. 10.

Fig. 12 is a cross-sectional view of the embodiment of fig. 11 along a longitudinal axis.

Fig. 13 is a cross-sectional view of the embodiment of fig. 11 after the addition of a prosthetic screw.

Fig. 14 is a top exploded isometric view of a third embodiment of an omnidirectional multi-unit foundation with a titanium base and a prosthetic screw.

Fig. 15 is a top isometric view of the embodiment of fig. 14 in a linear assembled configuration.

Fig. 16 is a cross-sectional view of the embodiment of fig. 14 along a longitudinal axis.

Fig. 17 is a top plan schematic view of a locking screw for the embodiment of fig. 14 having a hexagonal internal (Torx) drive feature.

Fig. 18 is a top plan schematic view of a locking screw for the embodiment of fig. 14 having four lobe internal drive features.

FIG. 19 is a top exploded isometric view of a four-lobe driver tip with locking screw and a base station base for the embodiment of FIG. 14.

FIG. 20 is an exploded top isometric view of a two-part abutment base bar with a sleeve and swivel mount for a fourth embodiment of an omnidirectional abutment.

FIG. 21 is a top isometric view of the assembled two-part abutment base stem with sleeve and swivel mount of FIG. 20.

FIG. 22 is a cross-sectional view of the assembled two-part abutment base stem with sleeve and swivel mount of FIG. 21 along a longitudinal axis.

Fig. 23 is a cross-sectional view of an application environment of a representative embodiment of an omnidirectional multi-unit abutment including a prosthesis and an implant.

Detailed Description

Various embodiments are included in the present disclosure to illustrate options for providing the benefits of an omnidirectional multi-unit base station for screw attachment. Fig. 1 and 2 illustrate an exploded view of one embodiment of an omnidirectional multi-unit base station 100, comprising four sections: a base 1, a rotary mount 2, a rotary base 3 and a locking screw 4. Representative titanium base 5 and prosthetic screw 6 are also shown in the exploded views of fig. 1 and 2. Such an omnidirectional multi-unit abutment assembly 100 may be made of titanium or any other suitable material for an implant abutment system, including noble and non-noble metals and alloys, ceramics and high strength engineering polymers (e.g. PEEK, PEI) or combinations of the foregoing. Treatments, coatings, or gels may be added to the surfaces or spaces between the components to prevent unwanted biological growth or promote healing. Fig. 3 shows the elements of fig. 1 and 2 in a linear orientation, except for the prosthetic screw 6. Fig. 4 shows the internal features of the assembly of fig. 3 taken along the longitudinal section designation A-A of fig. 3. Note that the presence of the titanium base 5 is shown in fig. 4 for descriptive purposes. The titanium base 5 is ultimately held in a prosthesis (not shown) and attached to an omnidirectional multi-unit abutment using a prosthesis screw 6, as shown in figure 6. The prosthetic screw 6 may be a permanent screw or may be a temporary fastener as described in commonly owned U.S. patent 11,311,354 and other continuing related applications. Fig. 6 is a perspective view of the assembly of fig. 1 and 2 in a linear configuration. Fig. 5 is a side view of an embodiment tilted about 30 degrees. Fig. 7-9 show the various stages of installing and adjusting this embodiment to the implant.

The abutment base 1 comprises a ball or spherical portion 13, which may be about 3.25mm in diameter, and has an abutment base drive feature 10 on the proximal end. As shown, the drive feature may be a T5 sized internal hexagonal internal (Torx) drive feature socket centered on the longitudinal axis at the top of the ball portion 13. Other types of driving tools may also be used. At the distal end of the abutment base 1 is a threaded portion 14 for attachment to the female thread of an implant 16, the implant 16 being fixed into the jaw of a patient. The implant 16 and its attachment to the mandible or maxilla is schematically described in this disclosure, as the inventive concept of an omnidirectional multi-unit abutment may be adapted to interface with different abutments. The general implant 16 shown in fig. 7 with female threads is of very general design, but the abutment base attachment 14 and the seat 21 may be adapted to conform to other implants.

The rotating base 3 comprises a hole 19 and an inner curved portion 15, which is sized and shaped to substantially match the curvature of the ball portion 13 of the abutment base 1. The illustrated swivel mount 2 comprises an internal thread 20 for attachment to the external thread 9 of the locking screw 4. It also includes a titanium base seat feature 22 for supporting and orienting the titanium base 5 when the titanium base 5 is mounted to the omnidirectional multi-unit console 100 with a prosthetic screw. The swivel mount may optionally include engagement features 11 that may be used to attach a tool, such as a wrench, to assist in assembly or limit the azimuthal orientation (not shown) of the titanium base 5. Limiting the orientation of the titanium base with the mating engagement features of the titanium base and implant abutment is a common technique for single tooth crowns. By fixing the azimuthal orientation of a non-cylindrical symmetric titanium base with a matching abutment mounting surface, the omnidirectional multi-unit abutment 100 embodiments herein are readily adaptable to single tooth prostheses and will not be described in detail.

The ball portion 13 of the abutment base 1 may be captured between the rotational base 3 and the rotational mount 2, which includes a rotational housing surrounding the ball portion 13, with the abutment base threaded portion 14 extending through the rotational base aperture 19. For this insertion process, the hole 19 must be larger than the base seat protrusion 21. The swivel base 3 and swivel mount 2 are preferably joined at an interface joint 12, the interface joint 12 being formed by continuous welding or spot welding (e.g., with a laser) after being positioned around the ball 13 to form the base assembly 101. This bonding technique provides a strong assembly of a relatively thin shell over a relatively short distance, but other bonding techniques may be used to capture the ball 13 within the shell. As shown in the cross-sectional view of fig. 4, after bonding, the mechanical design of the assembled rotating base 3 and the inner curved portion 15 and the hole 19 of the rotating mount 2 may be designed to prevent the ball portion 13 of the abutment base from coming out of the rotating housing. The relative size and shape of the aperture 19 and the size and shape of the abutment base 1 at the abutment projection 21 determine the range of possible tilting. Typically, if the minor diameter or width of both the rotating base bore 19 and the internal thread 20 of the rotating mount is smaller than the width of the ball 13, the ball 13 is captured within the housing without the locking screw 4.

The locking screw 4 is shown with external threads 9 to engage with internal threads 20 of the swivel mount 2. These threads may be, for example, m3 x 0.35 sizes. The locking screw 4 also has internal threads 7 for attaching the prosthetic screw 6 and an internal drive feature 8 for tool attachment to screw the locking screw 4 in the rotary mount 2. Representative prosthetic screw sizes include m1.4X0.3 threads, m1.6X0.35, UNF 1-72, and the like. The drive feature 8 may be a socket that houses a conventional dental driver including a Torx T5 or T6, 0.035 "to 0.050" hexagonal or square driver, or a similarly sized straight and star driver. As shown, the internal thread 7 and the drive feature 8 have a partial overlap along the longitudinal axis of the locking screw. This is a design choice. Complete axial overlap or no axial overlap is another design option.

The rotating base 3 is configured to engage a section of the spherical ball feature 13 when the locking screw 4 is tightened. The figures and cross-sections shown illustrate embodiments in which the rotating base and mount may be positioned and rotated anywhere within a 30 degree cone, as shown in fig. 5 and 8. The magnitude of the tilt allowed and the orientation of the adjustment are design choices, although a 30 degree tilt is often sufficient for most clinical applications. As shown in this embodiment, the threaded bore 20 in the swivel base bore 19 and swivel mount 2 is smaller than the diameter of the ball 13. In this case, when the rotation base 3 and the rotation mount 2 are attached to each other, the ball portion 13 of the abutment base can be loosely caught by both of these components. That is, the locking screw 4 need not be attached to the swivel mount 2 to form a housing that captures the ball 13 of the illustrated embodiment. This is a design option but is not necessary to benefit from the inventive concepts of the present disclosure.

The cross-sectional view of the omnidirectional multi-unit abutment embodiment with titanium base 5 in fig. 4 can be used to illustrate some of the advantages of the preferred geometric relationship between elements. As shown, the ball portion 13 is spherical throughout the range of motion of the housing formed by the rotating base 3, the rotating mount 2 and the locking screw 4. The range of inclination caused by the interference of the rotating base 3 close to the hole and the surface 61 of the base 1 close to the base portion 21 is limited to the angle b marked in fig. 5 and 9. The inner curvature of the swivel mount 2 is substantially the same as the curvature of the ball portion 13. The locking screw 4 also has substantially the same curvature as the ball 13 in the contact area. The inner curvature 15 of the swivel mount 2 is preferably slightly larger than the curvature of the ball 13. As a result, when the locking screw 4 is tightened, the ball 13 contacts the inner curved portion 15 of the rotating base 3 and the corresponding inner curved portion of the locking screw 4. Since the inner curvature of the swivel mount 2 is large, the swivel mount does not contact the ball when the locking screw 4 is fully tightened. This provides a more consistent continuous circular seal of the rotating base with the ball to help prevent biological contaminants from entering the interior of the omnidirectional multi-unit abutment assembly. In the linear configuration of fig. 4, the locking screw 4 also provides an equivalent circular seal with the ball portion 13. As shown in the maximally inclined state of fig. 9, the continuous sealing of the rotating base 3 against the ball is maintained. However, the sealing of the locking screw 4 to the ball 13 is not continuous due to the abutment drive feature 10. However, when the titanium base 5 and the prosthetic screw 6 are applied to the omnidirectional multi-unit abutment, the abutment drive feature 10 is effectively sealed.

The relatively large ring contact of the hollow locking screw 4 with the ball 13 distributes the clamping force over a larger area than the concentrated contact of a solid set screw. The expanding contact of the rotating base with the ball 13 and the matching curvature 15 have been determined to have sufficient frictional grip when the component is made of titanium to allow tightening of the locking screw 4 beyond 25Ncm without the need to hold the rotating base 3 or the rotating mount 4. The relatively large contact area also minimizes deformation of the ball 13 due to clamping compared to densely sold set screws, which makes it easy to reposition the tilt angle or azimuth without interference from deformation of the ball 13 geometry. The relatively large outer diameter of the locking screw 4 also provides a sufficient wall thickness between the internal thread 7 and the external thread 9 to obtain mechanical strength for applying a torque to the locking screw 4 with a driving tool size comparable to the thread width of the prosthetic screw 6.

The relatively large locking screw 4 provides a sufficient number of external locking screw threads 8 that engage the internal threads 20 of the swivel mount to provide a stable clamping force on the ball 13. Although threads (not shown) may also be used at the joint 12 between the rotary mount 2 and the rotary base 3, the omnidirectional multi-unit abutment diameter may need to be increased to have sufficient wall thickness and engaged thread depth to have strength equivalent to the relative dimensions shown in fig. 4. However, if it is desired to prevent over-torquing of the locking screw 4, a limited engagement of the threads between the rotating mount 2 and the rotating base 3 may be used to cause separation when a threshold torque is reached. Other options for torque limiting include adjusting the strength of the preferred weld joint described above, increasing the size of the hole 19 in the rotary mount, and/or introducing an intentionally thinner wall portion in the rotary base near the hole 19 with lower torque resistance. While an intentional failure design will likely result in loss of the omnidirectional multi-unit abutment, this may be preferable for overstressing that may lead to future failure of the prosthesis or implant retention.

The hollow locking screw 4 and driving geometry shown in fig. 4 provide benefits in dental system installation and maintenance. After the rotational base 3 is attached to the rotational mount 2 to form the base assembly 101, the ball portion 13 of the implant base is captured by the housing formed by the rotational mount 2 and the rotational base 3. The locking screw 4 may begin to enter the swivel mount 2 and swivel sufficiently to secure it but not contact the ball 13 to form the omnidirectional multi-unit base assembly 100. The titanium base 5 may optionally be placed on top of the omnidirectional multi-unit abutment assembly and components aligned along a common axis, as shown in fig. 3 and 4. The titanium base 5 need not be in place during installation and orientation of the abutment base 1, the rotation base 3, the rotation mount 2 and the locking screw 4. After such alignment, a drive tool 17 may be inserted through the titanium base 5 and the locking screw 4 to engage with the drive feature 10 of the abutment base 1, as shown in fig. 7. Note that it may be necessary to slightly rotate the driving tool 17 after passing through the locking screw 4 in order to engage the base station base driving interface 10. Preferably, the engagement cooperation of the drive tool 17 with the abutment base drive feature 10 has sufficient friction to retain the omnidirectional multi-unit abutment 100 on the drive tool 17, thereby presenting the omnidirectional multi-unit abutment assembly to the implant 16, as shown in fig. 7. A slight twist of the locking screw 4 in the loosening direction may assist in this retention. As the driving tool 17 is rotated, the abutment base screw thread 14 engages the implant 16 and the omnidirectional multi-unit abutment assembly may be screwed down to obtain the desired placement of the abutment portion 21 to the implant 16. Since the driving tool engages both the abutment base 1 and the locking screw 4, these components are rotated simultaneously. Since the position of the locking screw 4 is unchanged relative to the abutment base 1, the ball 13 is not gripped between the rotating base 3 and the locking screw 4. The rotational force from the driving tool 17 drives the abutment base screw thread 14 deeper into the implant 16.

The seat portion 21 of the abutment base that contacts the implant can be modified to match the seat geometry of the fixed angle abutment. The drive feature 10 allows the threaded portion 14 of the abutment base 1 to be secured to the implant 16. Tightening of the abutment base 1 to the implant may continue until the desired seating pressure is obtained at the abutment base 21. A representative torque value is about 30Ncm, although this value will depend on the implant system employed and may be higher or lower than this value. In order to load the prosthesis immediately, the torque value should be smaller than the torque value used for installing the implant into the jaw.

As shown in fig. 8, once the abutment base 1 is secured to the implant 16, the linear configuration of fig. 7 is no longer required. By movement of the driving tool 18 inserted in the locking screw 4, the inclination and azimuth angle of the rotary mount 2 to receive the titanium base 5, which is desired for the attachment of the prosthesis, can be selected. The driving tool 18 is turned to clamp the locking screw 4 and the rotary base 3 to the ball portion 13 and lock the angle of the omnidirectional multi-unit base 100. Engagement features 11 may be included to prevent rotation of the locking screw and the rotating base when the locking screw 4 is tightened. Other engagement features such as apertures or splines may also be used for this purpose as anti-rotation or azimuthal selection features. In the case of a monodentate prosthesis, the selection feature of the rotation fixation feature on the engagement titanium base on the rotation mount 2 allows to select and maintain the azimuth angle of the titanium base while tightening the locking screw 4. A coaxial two-piece tool that engages the anti-rotation feature and includes a drive tool similar to 18 may be used to orient and tighten the rotational mount 2 and locking screw 4 in place on the ball portion 13 of the base station base 1. Having a titanium base 5 included in the arrangement of fig. 5 may facilitate azimuthal selection.

The drive feature 7 of the locking screw 4 is preferably accessible through the titanium base 5 in both the temporary prosthesis and the final prosthesis. This allows the locking screw 4 to be moved and re-torqued in the proper orientation with the locking screw 4 loosened over time, fine-tuned to improve passive fit, and to replace and re-align one omnidirectional multi-unit abutment 100 within multiple omnidirectional multi-unit abutments 100. By comparing the driving tool size d1 shown in fig. 7a of the plot with the driving tool size d2 shown in fig. 8a of the plot, the driving tool 18 shown in fig. 8 is larger than the driving tool 17 in fig. 7. This is not necessary. The benefit of using two different sized drivers (e.g., T5 driver 17 for driving the abutment base 1 and T6 driver 18 for securing the locking screw 4) is to provide additional clearance in the locking screw 4 when driving the abutment base. Since the torque for driving the abutment base part 1 can be selected to be higher than the torque for locking the screw 4, a first torque wrench with a driving tool 17 and a second torque wrench with a driving tool 18 can help to ensure that the desired torque is obtained. Of course, in order to allow the assembled omnidirectional multi-unit base 100 to be installed into the implant 16 as shown in fig. 7, the driving tool 17 must be sized and shaped to pass through the locking screw 4. The driving tool 18 in fig. 8 is prevented from passing completely through the locking screw 4, because the shown driving interface 8 in the locking screw does not extend all the way to the distal side of the locking screw 4. This is a design choice.

Some practitioners may choose to use their muscle memory experience rather than a calibrated objective tool to determine when a predetermined desired torque is applied to the abutment base 1 and locking screw 4. If the base drive interface 10 and the locking screw drive interface 8 are the same size and shape, one tool may be used for the drive tools 17 and 18. In this case, after driving the abutment base 1 into the implant 16 as shown in fig. 7, the driving tool 17 will only need to be withdrawn just enough to disengage from the abutment base drive interface 10 before repositioning the driving tool 17 to lock the position of the omnidirectional multi-unit abutment 100 by rotating the locking screw 4. If different calibration torques are desired, two different wrenches with the same driving tool tip size may be used. Some practitioners may prefer to have the drive tip inserted into the omnidirectional multi-unit base for both torque process steps and switch torque wrenches set to different values. Since the axis of rotation of the driving tool 17 is generally different from the driving tool 18, it may be acceptable to use the same torque amplitude for the base station base 1 and the locking screw 4. It may be useful to have a button or other selector to switch between two different torque settings. The automatic selection may be based on the difference in deeper drive tool depth required to engage the base drive interface 10 as compared to the locking screw drive interface 8, for example by requiring force along the axis of the drive tool tip to engage the spring loaded sheath with a higher torque mechanism. In this case, the lower torque device may remain engaged if desired, although it may slip.

Fig. 9 shows a cross-sectional view of an omnidirectional multi-unit abutment assembly 100, comprising a prosthetic screw 6 holding a titanium base 5. The prosthetic screw 6 may be replaced with a separable fastener (not shown) as described in reference to us patent 11,311,354 to facilitate positioning of the titanium base 5 into the prosthesis by a lift-off process. Note that the locking screw drive interface 8 can be accessed by removing the prosthetic screw 6 even after the titanium base 5 is incorporated into the prosthesis. This basically changes the configuration from fig. 9 to fig. 8. This benefit will be described in more detail after other embodiments are presented.

A variation of the embodiment shown in fig. 1 to 9 is shown in fig. 10 to 13. From a practical design standpoint, given the constraints of conventional abutment diameter, seat height (in the first embodiment, the distance between the seat surface 22 of the titanium base 5 and the implant seat surface 21), and other dimensional constraints, an omnidirectional multi-unit abutment design may also include embodiments in which the abutment base 30 and the ball or spherical feature 31 are initially separate components. In the embodiment of fig. 1-9, the diameter of the ball is about 3mm. A nominal seat height of about 2.5mm is shown in the figures.

The second embodiment, shown in fig. 10-13, is shown having substantially the same dimensions to work with the same implant 16 and titanium base 5 as the omnidirectional multi-unit abutment assembly 100 shown in fig. 1-9. The seat height between the base seat 42 and the titanium base seat 41 is also comparable. The main difference is that the swivel 32 is captured between portions of the two-part base station base 30. The abutment base 30 in fig. 12 comprises a separate ball 31 attached to a stem portion 34. For example, a discrete piece (discrete) 31 may be useful where the rotating base does not interfere with the passage of the desired abutment diameter. Thus, the embodiment of fig. 10-13 includes a ball 31 having a drive interface 45 with a distal mounting hole 46 that attaches with the mating post feature 35 of the abutment base stem portion 34. After the ball 31 is inserted into the rotator 32, the ball 31 is assembled to the base stem portion 34 by any form of mechanical engagement (e.g., press fit, heat shrink, laser welding, adhesive, or a combination thereof). For example, the ball 31 may have a slight press fit on the post 34 and a small radial laser weld at the interface 35. The method reliably bonds the ball to the base while minimizing mechanical precision, provides a fillet at the mating joint 35, and seals the joint from liquid ingress.

In the illustrated embodiment, the small diameter of the internal threads 38 of the swivel 32 is large enough to allow the ball 31 to be inserted through the internal threads 40 of the swivel 32. The drive interface 45 may be used to orient the ball for assembly. After capturing the rotator 32 and installing and tightening the locking screw 33, the ball 31 contacts the rotator 32 along the seating surface 47. About 17.5 degrees of seating/interference surface is shown in fig. 12-13. The locking screw 33 is also in contact with the ball 31 along the interface 48. Various surface finishes and mechanical features may be employed to enhance the locking of mating surfaces 48 and 47 to ball 31, such as surface texture, ridges or ribs. Note that this method of capturing the spin 32 to the ball prevents the spin 32 from falling off the ball 31. Similar to the rotating base 3 of the first embodiment of fig. 1-9, the rotating member 32 contacts the distal surface of the ball, but a titanium base seat 41 is also provided to support the titanium base 5 in a known orientation similar to that provided by the previously described titanium base seat 22 of the rotating mount 2.

The locking screw 33 is similar to the locking screw 4 in the first embodiment. The locking screw 33 includes a prosthetic screw thread 36, a drive socket feature 37, a seat surface 48, and external threads 39. The proximal end of the ball portion 31 includes a drive socket feature 45 that is accessible by the locking screw 33, similar to the locking screw 4 described above. When the locking screw 33 is tightened using the drive feature 37, the rotating member 32 engages the seat surface 47 of the ball 31, which allows the locking screw 33 to secure the rotating member 32 in a desired omni-directional orientation up to thirty degrees from the implant axis and at a desired azimuth angle. Also, during installation and orientation of the omnidirectional multi-unit base station, the titanium base 5 need not be present. By appropriate selection of the dimensions of the prosthetic screw thread 36 and the drive features 45 and 37 and 44, a single drive tool may be used for the following three steps: the abutment base 30 is secured into an implant (not shown), the orientation of the rotary member 32 is locked with the locking screw 33, and the prosthetic screw 44 is secured. For example, if the drive interfaces 37, 44 and 45 also have T5 socket characteristics, a typical single T5 drive tool for the M1.6X0.35 prosthetic screw 43 with threads 36 may be used. Of course, in this case, the locking screw drive interface 37 would need to extend through the locking screw 33 (not shown) in order to engage the abutment base drive socket feature 45. The portion of the M1.6 prosthetic screw thread removed for the T5 driver has been determined to provide sufficient thread integrity to properly retain the prosthetic screw. Other standard and custom thread and drive geometry combinations may also be used to allow the use of a single drive tool.

By assembling the ball 31 to the abutment base 30, the abutment base 30 can have a greater width at the implant placement location 42 than in the first embodiment. In the first embodiment, the threaded end 14 of the abutment base 1 is inserted into the rotation base hole 19 to contact the ball 13. The ball portion 13 is captured by coupling the swivel mount 2 to the swivel base 3. By incorporating the features of the rotating base 3 and the rotating mount 2 into a single piece rotating member 32 in this embodiment, the size of the distal end of the base is not limited by the hole at the distal end of the rotating member 32 hole. In the embodiment of fig. 10-13, the small diameter of the locking screw external thread 39 must be greater than the diameter of the ball 31 to allow the ball to be inserted through the swivel 32 to be coupled to the abutment base 30. A comparison of fig. 12 with fig. 4 shows that this results in a shorter depth for engaging the threads between the swivel 32 and the locking screw 33.

Fig. 14-16 illustrate another method of capturing a rotating housing component to a base station base having a spherical feature. In this embodiment, the base station base assembly 101 is made of a rotating member 32 and a ball with a tapered rod 50 having a ball feature 13, a drive feature 45 at the proximal end and a tapered rod 51 at the distal end. The tapered rod 51 is coupled to a base 52, the base 52 having a tapered socket 53 at a proximal end and base threads 14 at a distal end. The widest part of the ball with tapered rod 50 is the diameter of ball 13. The rotating member 32 is captured by inserting the tapered rod 51 into the proximal side of the rotating member 32 and then inserting the tapered rod 51 into the tapered socket 53.

Fig. 15 and 16 show a base station base assembly 101. As previously mentioned, the tapered rod 51 and the base 52 may be combined using different techniques. However, it is preferred to include a weld at interface 63. A comparison of fig. 16 with fig. 14 shows that the ball portion 13 of the ball with tapered rod 50 may have improved structural stability compared to the base portion ball 31. This may be important in view of the small size of the components and the desire to have a smooth rotational action and tight sealing of the components when locked in place.

The locking screw 49 shown in fig. 14 differs from the locking screws 4 and 33 of the previous embodiments in that it includes a hex drive feature 64 on the outer surface near its proximal end. The hex drive feature 64 is configured to facilitate removal of the failed device. For example, if the prosthetic screw 25 breaks in the locking screw 4, the locking screw drive interface 8 may become plugged such that the drive tool 18 for installing the omnidirectional multi-unit abutment cannot be inserted. As an alternative to removing the broken stem 25, a wrench (not shown) may be applied to the hex feature 64 to remove the locking screw 49. Of course, with the titanium base 5 in place on the omnidirectional multi-unit submount, these hex features 64 will generally not be accessible. As a result, for using a titanium base in an implant, locking screw drive interface 37 is preferred to help align and lock the omnidirectional multi-unit abutment orientation, thereby improving the passive fit. If desired, a wrench may also be applied to the flats 11 on the sides of the rotating member 32 to assist in removing the jammed locking nut 49, as the titanium base 5 does not cover it.

Fig. 17 is a top plan view of the locking screw 49. At the outer edge is a locking screw external thread 39 and at the center is a locking screw internal drive interface 8, shown as Torx type. A large diameter 66 (dashed line) and a small diameter arc 65 of the locking screw internal thread 7 are shown. The small diameter 65 is not a continuous circle, but a series of discrete arcs, as the locking screw internal drive interface 8 axially overlaps the locking screw internal thread 7. Note that the locking screw 49 has a locking screw internal drive interface 8 and internal threads 7 that extend all the way through the locking screw 49. In other words, they overlap axially substantially entirely through the thickness of the locking screw 49, such that both the sufficiently long prosthetic screw thread 25 and the driving tool 18 can pass through the thickness of the locking screw 49. The amount of material in the locking screw 49 that is available for the driving tool 18 to apply torque to lock the orientation of the omnidirectional multi-unit base 100 corresponds to the volume defined by the major diameter 66 and the minor diameter 65 of the internal thread 7 minus the material removed to provide the locking screw drive interface 8 socket for the driving tool 18 (not shown). The size and shape of the driving tool interface 8 may be modified to vary the strength of the remaining internal threads 7 for holding the prosthetic screw 6 and the maximum torque applied to the locking screw 49 to fix the orientation before damaging the internal threads 7.

Fig. 18 is a top plan view of a locking screw 49 with an alternative drive interface 54 within the locking screw. The drive tool interface 49 has 4 lobes instead of the 6 lobes of the Torx drive tool interface shown previously. The visual comparison with fig. 17 is sufficient to show that more internal threads remain compared to fig. 17 due to fewer lobes and more pronounced lobe transitions. Thus, there is a tradeoff in materials and geometry that can be used to compensate for any mechanical strength degradation caused by the axial overlap of the internal threads 7 and the locking screw drive interface 54, which allows for the final alignment and locking of the omnidirectional multi-unit abutment 100 with the prosthesis in place.

Fig. 19 shows a 4-lobe drive tip 62 with the locking screw 49 of fig. 18 and the abutment base 59 with a mating 4-lobe drive interface 60. Other components of the omnidirectional multi-unit base 100 are not shown for clarity. Since the drive tip 62 is sized to pass through the locking screw 49, it can be used to drive the abutment base 59 into the implant 16 (not shown). Since the drive tip is sized to pass through the aperture 23 (not shown) of the titanium base, it can also turn the locking screw 49 to fix the position of the omnidirectional multi-unit abutment through the prosthesis (not shown) in which the titanium base 5 (not shown) is embedded.

Fig. 20 shows another embodiment of a two-part base station base 55 assembled to capture the swivel 32. In this embodiment, the ball 13 and the abutment base screw 14 are included in the abutment base stem 56. The distal end of the cue stick is inserted into the swivel 32 and then into a hollow sleeve 57 that matches the interface requirements of the cue stick 16 to be used. The sleeve 57 has a maximum width greater than the diameter of the ball portion 13. As a result, when the sleeve 57 is coupled to the base shaft 56, the rotary member 32 is captured. Any of the various joining operations described above may be used, although it is preferred to include welding at interface 58 as shown in fig. 22. Fig. 22 also shows two critical dimensions for the above-described assembly process. The minimum diameter "d" of the through hole of the rotary member 32 must be greater than the maximum width "c" of the abutment base bar 56 below the ball. Because of the similarity of this embodiment with the prior embodiments, the other components and features will not be described.

Many other methods of capturing the rotating member on the ball are possible with the abutment connection assembly attached, such as a differently shaped male pin on the ball, a female socket on the abutment base, a threaded rod on the ball or abutment. While a substantially spherical ball has been shown to demonstrate the concepts of the present invention and provide maximum orientation flexibility, other shapes may be used to intentionally limit orientation. The mating interfaces may be adapted to meet the objectives in an otherwise non-presented embodiment that still uses one or more of the illustrated inventive concepts.

Fig. 23 shows a cross-sectional view of the application environment of the installed omnidirectional multi-unit base station 100 of the first embodiment. Implant 16 has been installed in the bone and soft tissue of a patient, schematically indicated 70. The abutment base part 1 has been screwed into the implant 16 to the desired torque level. In this case the rotary mount 4 has been tilted to its maximum capacity substantially corresponding to fig. 8. The titanium base 5 is embedded in the prosthesis 68. The occlusal surface 72 of the prosthesis is schematically shown as 72. The titanium base 5 is placed on the rotary mount 4 but the prosthetic screw 6 has been removed to allow the locking screw interface 8 to be accessible by the driving tool 71 through the prosthetic screw access hole 69. Note that while a 4-lobe drive tool 71 is shown, a smaller drive tool (not shown) may be required to drive the abutment base 1 into the implant 16, as described above for the first embodiment. As described in the first embodiment, it may be advantageous to be able to make changes in the orientation of the omnidirectional multi-unit abutment when the prosthesis is in place. Fig. 23 will be used to describe this in more detail.

Although only one implant is shown in fig. 23, the benefits of in situ adjustment are exaggerated when the prosthesis includes multiple titanium bases mated to multiple implants. Uncertainty in the position of the titanium base may accumulate during manufacture or modification of the prosthesis for implant installation. Due to the random nature of these displacements, the orientation and position of the titanium base may deviate from each other and from the position of the set of bases originally used to orient the titanium base with the prosthesis. Even if the titanium base is initially perfectly positioned, the shape of the patient's jaw or prosthesis will change over time. As shown in fig. 23, removal of the prosthetic screw 6 allows the locking screw 4 to be accessed and loosened by the driving tool 71. Application of a repositioning force from the occlusal side 72 to the prosthesis 68 will urge the embedded titanium base 5 against the titanium base seat 22, thereby redirecting the orientation of the omnidirectional multi-unit abutment. Tightening the locking screw 4 with the driving tool 71 while maintaining the repositioning force on the prosthesis 68 will lock the orientation. The prosthetic screw 6 can then be reinserted and twisted to secure the titanium base 5 and the prosthesis 68 in place. This can also be done by embedding the titanium base 5 in the prosthesis 68 if it is desired to check the torque on the locking screws 4 to see if they have loosened over time.

Similarly, if one of the omnidirectional multi-unit abutments 100 in a set fails and needs to be replaced, the prosthesis 68 with its embedded titanium base 5 can be removed after removal of all the prosthesis screws 6. Reversing the angular setting and implant attachment process shown in fig. 8 and 7 will remove the failed omnidirectional multi-unit base assembly 100. Repeating the process of fig. 7 to attach a new omnidirectional multi-unit abutment 100 to the implant 16 will result in the abutment base 1 being fixed into the implant 16, but the housing consisting of the rotational base 3, the rotational mount 2 and the locking screw 4 will be loose. The minimum pressure on the locking screw 4 is sufficient to maintain the orientation of the omnidirectional multi-unit base such that gravity does not cause it to move, but only requires the application of a minimum force to change its orientation. The rough positioning of the rotational mount 4 is sufficient to engage the titanium base 5 in the prosthesis 68 and manually apply pressure to the prosthesis from the occlusal side 72, which will reorient the newly installed omnidirectional multi-unit abutment to align with the titanium base 5 already installed in the prosthesis. The locking screw 4 can then be screwed in place through the hole 23 in the titanium base 5, as shown in fig. 23. It is optional whether the prosthetic screw 6 from the original omnidirectional multi-unit abutment 100 is used to maintain alignment pressure on the newly installed omnidirectional multi-unit abutment 100 prior to tightening the locking screw 6.

Since the locking screw drive interface 8 is accessible through the titanium base 5 and the prosthesis 68, a variation of one screw passive fit test scheme can be used to fine tune the orientation of the omnidirectional multi-unit abutment to improve the passive fit at the time of original installation. There are different options to exploit the ability to reorient the omnidirectional multi-unit abutment 100 through the aperture 23 of the titanium base 5 mounted in the prosthesis 68. In one approach, all of the prosthetic screws 6 are removed. When the prosthesis 68 is held in place, all of the omnidirectional multi-unit abutment locking screws 4 are loosened and then tightened with a finger to provide a certain frictional resistance, but not prevent rotational slippage. The actual torque value for proper finger tightening will depend on the construction and surface finish of the omnidirectional multi-unit base, but will typically be less than a few Ncm. Then, all the prosthetic screws 6 are reinstalled and twisted to the recommended value. In this way, the orientation of each omnidirectional multi-unit abutment will more closely match the dental prosthesis 68. Next, the single prosthetic screw 6 is removed to provide access to the locking screw 4 of the omnidirectional multi-unit abutment at that location. The locking screw 4 is twisted to its predetermined value. The prosthesis screw 6 is reinserted and twisted to a predetermined value. The process is repeated until all the omnidirectional multi-unit abutment locking screws 4 have been tightened and all the prosthetic screws 6 have been tightened.

The fine tuning process above may be modified based on an initial level of detail of the passive fit. For example, it may be desirable to loosen only some of the omnidirectional multi-unit abutment locking screws 4 while remaining stationary as anchor points for the original prosthetic fit. This may be due to the requirement to compromise the passive fit to some extent for better occlusion or other reasons. Alternatively, the results of a conventional one screw or screw resistance test may suggest directional adjustment or a different order of adjustment of only a subset of the omnidirectional multi-unit base stations. In any event, these passive fit improvements directly result from the ability to orient and fix the omnidirectional multi-unit abutment when the prosthesis is in place.

Preferably, the above embodiment of the omnidirectional multi-unit base 100 is adapted to be compatible with both a titanium base 5 and a threaded implant 16 that have been approved and commercially successful. Since the same implant can be used with a conventional straight abutment and the above embodiments in the same patient, the inventory formula is improved for widely available threaded connections and placement of implants. Although less critical, compatibility with widely available screw attached titanium bases 5 is also seen as an advantage. However, the inventive features of the embodiments may be integrated into or adapted to work with newly designed implants employing the inventive concepts for passive fit improvement or installation efficiency and repair described above. These inventive concepts may also be adapted to work with prostheses that are not attached with screws. Such adaptations are not to be excluded and are considered to be disclosed herein and are within the scope of the claims which may be construed broadly to apply to them. Us patent 11,311,354 includes different methods of aligning a titanium base with a abutment for incorporation into a prosthesis using temporary fasteners during lift-off. The basic design of the temporary fastener shown in this commonly owned patent can be used with the omnidirectional multi-unit abutment and titanium base described above.

Various embodiments have been described to illustrate the disclosed inventive concepts, not to limit the invention. It is considered a part of this disclosure to combine the inventive elements of one or more embodiments with known materials, components, and techniques in dental science to create additional embodiments using the inventive concepts.

Claims

1. A system for aligning and attaching a dental prosthesis to an implant using a prosthetic screw, wherein the prosthetic screw includes a head and a threaded shaft, the system comprising:

a distal end comprising threads for attachment to the implant; and

Locking the screw drive interface; and

wherein rotating the locking screw can fix an orientation of the longitudinal axis of the locking screw in an orientation that is not parallel to the longitudinal axis of the abutment base.

2. The system of claim 1, wherein the ball portion of the abutment base is compressed between a portion of the inner surface of the rotating housing and the locking screw.

3. The system of claim 1, wherein the rotating housing comprises a rotating base and a rotating mount that are mechanically assembled to capture the ball portion of the base station base.

4. The system of claim 1, further comprising a titanium base, wherein the titanium base has a hole at a proximal end that is larger than the prosthetic screw threaded shaft and smaller than the prosthetic screw head, and the titanium base has a distal end shaped to be supported by the rotating housing in a known orientation.

5. The system of claim 1, wherein the base drive interface is a socket for receiving a base drive tool, and wherein the base drive tool has a longitudinal axis and a base drive tip shaped to engage the base drive interface.

6. The system of claim 1, wherein the locking screw drive interface is a through socket for receiving a locking screw drive tool, and wherein the locking screw drive tool has a longitudinal axis and a maximum width that is less than a maximum width of a threaded shaft of the prosthetic screw.

7. The system of claim 6, wherein the locking screw driving tool is sized to pass through the aperture of the titanium base without interference.

8. The system of claim 6, wherein the abutment drive tool tip is sized to pass through the locking screw.

9. The system of claim 8, wherein the abutment drive tool tip is designed to tighten the abutment base into the implant to a first torque without simultaneously tightening the locking screw to fix the orientation of the rotating housing.

10. The system of claim 7, wherein the orientation of the rotating housing is selected by tilting the locking screw driving tool away from a linear axis of the base station base and tightening the locking screw to a second torque.

11. The system of claim 10, wherein the abutment drive tool tip is used to tighten the locking screw.

12. A method of aligning and attaching a dental prosthesis to an implant with a prosthetic screw using the system of claim 1, the method comprising:

presenting a base station base drive tool and a multi-unit base station assembly to the implant;

moving the rotating housing to a different orientation;

the prosthesis is attached to the implant abutment with a prosthesis screw.

13. The method of claim 12, further comprising applying a force to the prosthesis to move the rotating housing into alignment with the titanium base.

14. The method of claim 12, wherein the titanium base is incorporated into the prosthesis using a lift-off process with a temporary fastener comprising:

a post having an axis, a first post end and a second post end, wherein the first post end has threads for threaded attachment to the locking screw; and

a cap, wherein the cap is attached to the second post end;

and wherein the temporary alignment fastener is configured to hold the titanium base against the rotating housing by applying a rotational force to the cap to screw the first post end into the locking screw, and wherein the cap is separable from the post by a release force directed away from the first post end.

15. A system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment, the multi-unit implant abutment comprising:

a ball and housing assembly, the ball and housing assembly comprising:

16. The system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment of claim 15, wherein the titanium base is incorporated into a prosthesis, and wherein when the locking screw is tightened, a force is applied to the prosthesis to align the multi-unit abutment with the titanium base.

17. The system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment of claim 15, further comprising a prosthesis screw, wherein the prosthesis screw comprises:

a head having a width greater than the titanium base aperture; and

a threaded shaft portion having a smaller width than the titanium base hole; and

wherein the locking screw comprises threads for receiving threads of the prosthetic screw.

18. The system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment of claim 17, wherein the locking screw comprises a longitudinal bore comprising:

an internal thread for engaging the prosthesis threaded shaft; and

a drive interface for receiving a tool for tightening the locking screw.

19. The system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment of claim 15, wherein the base is comprised of two components, and wherein the two parts are joined with a shell aperture captured between the two components.

20. The system for aligning and attaching a dental prosthesis to an implant using a multi-unit implant abutment of claim 15, wherein the locking screw has a longitudinal bore, and wherein the bore is sized to allow the abutment driving tool to extend through the locking screw.